Government rules out addition of more money to the existing Medicare system

The Federal Health Minister, Mark Butler, has all but ruled out increases to the Medicare rebate to encourage more GPs to offer bulk billing despite ongoing calls from the Royal Australian College of General Practitioners (RACGP).

Minister Butler acknowledged that “it’s never been harder to see a general practitioner or a doctor out in the community than it is right now. We’ve heard that from Australians now for many months, and it’s never been more expensive, particularly after six years of a freeze on the Medicare rebate. Gap fees have skyrocketed over the last decade: for a standard GP consult, for the first time in the history of Medicare, the average gap fee is now more than the Medicare rebate fee itself.”

Minister Butler made it clear that doing “more of the same is simply not going to cut it. Strengthening Medicare means also modernising Medicare.”

Moving from a purely fee-for-service model that has largely defined Medicare over the last 40 years to something that’s more blended, that has more wraparound funding, particularly for older patients and patients with complex chronic disease, will be a key consideration of the reforms.

“We’ve seen gap fees for specialists climb even faster and higher than gap fees have climbed for GPs. The MBS rebate freeze didn’t just impact general practice, it also impacts specialists as well. So there’s financial pressure right across the healthcare system, and too many patients are feeling that in their hip pocket,” Minister Butler added.

“Too many regulations, constraints within the MBS system and turf wars” constrain the expansion of pharmacists and nurses roles in managing patients, according to the Health Minister.

Devising a plan to open delivery of primary care to other health professionals, with a new funding model that funds nurses and allied health professionals working in teams delivering complex care, has not been welcomed by the RACGP.

RACGP President, Dr Nicole Higgins, said GP stewardship of patient care in the community needs to be central to any long-term reforms.

“While it’s great that our nation’s leaders recognise the need for reform, I am concerned the government’s proposed new model to overhaul Medicare will not go far enough to improve the situation for patients and may make matters worse.

“We have seen other countries such as the United Kingdom try to address GP shortages by broadening delivery of primary care to other health professionals – this approach failed to meaningfully improve patient health and wellbeing. Instead, it further fragmented the health system, which leads to worse health outcomes, inefficiencies, and wastage.

“The evidence shows seeing the same GP over time, also known as ‘continuity of care’, leads to fewer hospital visits, lower mortality, and reduced costs to the health budget. So, we need GPs working hand in glove with allied health professionals, pharmacists, and practice nurses, and they should be supported within general practice, with GPs working as the stewards of patient care.”

The final report of the Strengthening Medicare Taskforce will be released in the next couple of weeks. It will guide the decisions that the government needs to take in the May Budget to finalise the investment of that Strengthening Medicare Fund.

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